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Hospital-based inpatient resource utilization associated with autosomal dominant polycystic kidney disease in the US
Christopher M Blanchette1, Christopher Craver, Kathy W Belk
1University of North Carolina , Charlotte, NC , USA.
Insights
Autosomal dominant polycystic kidney disease (ADPKD) patients utilize fewer hospital resources than chronic kidney disease (CKD) patients but experience more kidney complications and surgeries. This highlights the significant burden of ADPKD.
Area of Science:
- Nephrology
- Genetics
- Healthcare Management
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a leading genetic cause of end-stage renal disease (ESRD).
- Limited data exists on the healthcare resource utilization and patient characteristics for ADPKD.
- Understanding ADPKD inpatient utilization is crucial for developing strategies to slow disease progression and reduce healthcare costs.
Purpose of the Study:
- To assess hospital-based inpatient utilization among patients with ADPKD in the United States.
- To compare patient characteristics and healthcare resource utilization between ADPKD and chronic kidney disease (CKD) cohorts.
- To identify factors contributing to the healthcare burden of ADPKD.
Main Methods:
- A cross-sectional analysis of 1876 hospitalized patients using MedAssets Health System Data.
- Comparison of demographic, clinical characteristics, complications, surgical interventions, and length of stay between ADPKD and CKD patients.
- Inclusion of measures like Charlson Comorbidity Score and primary payer information.
Main Results:
- ADPKD patients were younger (mean 57.9 vs. 69.5 years) and generally healthier (Charlson Comorbidity Score 2.0 vs. 3.3) than CKD patients.
- ADPKD patients had a shorter average hospital stay (6.3 vs. 10.3 days) and were more likely to have commercial insurance.
- ADPKD patients showed higher rates of kidney-related complications and surgical procedures, primarily for transplant and nephrectomy.
Conclusions:
- Despite being generally healthier, ADPKD patients face more frequent kidney-specific complications.
- A higher incidence of major kidney procedures in ADPKD contributes significantly to inpatient resource utilization.
- Further research is needed to manage ADPKD complications and optimize healthcare resource allocation.
Objective:
Polycystic kidney disease (PKD) is a clinically and genetically heterogeneous class of genetic disorders characterized by development of renal cysts leading to renal failure and end stage renal disease (ESRD). Autosomal dominant polycystic kidney disease (ADPKD) accounts for the majority of PKD cases and is the predominant monogenic cause of ESRD. Limited information on patient characteristics and healthcare resource utilization is available in this population. This study assessed hospital-based inpatient utilization of patients with ADPKD in the US to help further understand the disease, which may lead to treatments that delay progression and reduce healthcare resource utilization.
Methods:
A cross-sectional analysis was conducted using MedAssets Health System Data to investigate inpatient resource utilization for a total of 1876 patients hospitalized with ADPKD or chronic kidney disease (CKD). Patient characteristics and inpatient resource utilization were compared between hospitalized patients with ADPKD and CKD, including demographic and clinical characteristics, overall health, rates of complications and surgical interventions, and average length of hospital and intensive care unit stay.
Results:
Compared with patients with CKD, patients with ADPKD were more likely to have commercial insurance as their primary payer (36.1 vs 17.8%) and were significantly younger (mean age 57.9 vs 69.5 years) and generally healthier (Charlson Comorbidity Score of 2.0 vs 3.3). Patients with ADPKD also had a substantially shorter average length of hospital stay (6.3 vs 10.3 days). However, patients with ADPKD experienced more kidney-related complications and a higher surgical procedure rate (mainly for transplant and complete nephrectomy).
Conclusions:
Although patients with ADPKD were generally healthier than patients with CKD, specific kidney function complications were more frequent. Patients with ADPKD had a higher rate of major kidney procedures, which may contribute to the high burden of ADPKD-related hospital-based inpatient resource utilization.
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